Objective To retrospectively evaluate the clinical efficacy and safety of brentuximab vedotin(BV) combined with chemotherapy in the treatment of malignant lymphoma. Methods We collected the data of 32 lymphoma patients with CD30-positive status, including 14 cases of Hodgkin's lymphomas, 2 cases of diffuse large B-cell lymphomas, and 16 cases of mature T/NK cell lymphomas. Chemotherapy combined with BV was administered to all patients for a minimum of two cycles. The efficacy of the treatment was evaluated according to Lugano criteria every two cycles. Results Complete response rate and overall response rate after four cycles of treatment were 22% and 50%, respectively. Sixteen cases (50.0%) had grades 1 and 2 toxicity, and 16 cases (50.0%) had grade 3 toxicity or higher. The most common adverse events were neutropenia (50.0%), pneumonia (46.9%), and anemia (43.8%). The most common grade 3 or higher adverse events were pneumonia (18.8%) and febrile neutropenia (12.5%). Four patients discontinued brentuximab vedotin because of severe adverse events. Conclusion BV is effective in treating relapsed and refractory CD30- positive Hodgkin's lymphoma and peripheral T-cell lymphoma, and its overall safety is acceptable.

【Objective】 To explore the surgical characteristics and clinical efficacy of percutaneous endoscopic visualization trephine for thoracic spinal stenosis. 【Methods】 We made a retrospective analysis of 37 patients with single-segment thoracic spinal stenosis treated with percutaneous endoscopic visualization trephine from January 2019 to June 2020. Among them， there were 14 males and 23 females； their age ranged from 31 to 82 years old， with an average of （57.6±11.8） years old. Their posture， length of hospital stay， length of operation and blood loss were recorded. The visual analogue scale （VAS）， Oswestry disability index （ODI） and the modified Japanese Orthopaedic Association （JOA） score were used to evaluate the preoperative and final conditions of patients and calculate the improvement rate. 【Results】 The operation was successfully completed in all the patients， and no patients developed epidural hematoma， incision infection or postoperative paralysis. Among the 37 patients， 24 ones with ossification of ligamentum flavum （OLF） were in the prone position， and 13 patients had lateral surgery. Among them， thoracic disc herniation （TDH） occurred in 3 cases， OPLL in 5 cases and OLF+OPLL in 5 cases. The hospital stay was （7.2±1.6） days， the operation time was （96.5±20.0） min， and the blood loss was （41.9±10.8） mL. VAS score decreased from （7.0±0.9） to （1.9±0.8）； ODI improved from （41.7±2.1） to （16.1±1.7）； and JOA score increased from （5.8±1.4） to （8.6±1.4）. The preoperative and postoperative differences were statistically significant （P<0.05）. 【Conclusion】 Percutaneous endoscopic visualization of thoracic spinal stenosis is treated by choosing different positions according to the type of compression. The spinal canal is fully decompressed. The surgical method is safe and minimally invasive， and the postoperative effect is satisfactory.

OBJECTIVE：To study the mechanism of Periplaneta americana extract degreasing cream and CⅡ-3（shorted for “degreasing cream ”and“CⅡ-3”）reversing the multi-drug resistance of human HepG 2/ADM cells. METHODS ：MTT assay was used to investigate the toxicity effects of different concentrations of sorafenib （positive control ），degreasing cream and C Ⅱ-3 on HepG2/ADM cells ，then IC 20 was calculated. The experiment was divided into sensitivity drug ，drug-resistance group ，sorafenib group，degreasing cream group and C Ⅱ-3 group. HepG 2 cells were included in sensitivity group ，and HepG 2/ADM cells were included in the latter 4 groups. Sensitivity group and drug-resistance group were treated with routine medium ，and other 3 groups were treated with relevant medicine （IC20 as drug concentration ）. The content of ADM in HepG 2/ADM cells was determined by Laser scanning confocal microscopy. The expression of apoptosis-related protein as Bcl- 2 and Cleaved-Caspase- 9 p37 were detected by Western blotting assay. RT-qPCR and immunocytochemistry were adopted to detect mRNA and protein expressions that related to multidrug resistance [P-gp （expression produce of MDR1 gene），LRP，BCRP] and that related to enzyme-mediated multidrug resistance pathway （GST-π and Topo Ⅱ）. RESULTS ：The IC 20 of degreasing cream ，CⅡ-3 and sorafenib were （2.40±0.16）， （200.44±27.52），（18.00±1.82）μg/mL，respectively. Compared with sensitivity group ，the protein expressions of Bcl- 2，P-gp， LRP，BCRP and Topo Ⅱ，the mRNA expressions of MDR 1， LRP，BCRP and GST-π were increased significantly in drug resistance group （P＜0.05 or P＜0.01）. Compared with @qq.com drug-resistance group ，the mRNA and protein expression of MDR1 mRNA and LRP ，BCRP，GST-π were significantly decreased in degreasing cream group and C Ⅱ-3 group（P＜ 0.05 or P＜0.01）；the protein expression of Bcl- 2 and the mRNA expression of Topo Ⅱ were significantly decreased （P＜0.01）， while the protein expression level of Cleaved-Caspase- 9 p37 was significantly increased in C Ⅱ -3 group （P＜0.05）. CONCLUSIONS：Degreasing cream and C Ⅱ-3 can reverse multidrug resistance of HepG 2/ADM cells by reducing drug efflux ， promoting cell apoptosis ，reducing the mRNA and protein expression of multi-drug resistance gene as well as gene in enzyme-mediated multi-drug resistance pathway. The effect of C Ⅱ-3 is better than that of degreasing cream.

Objective:To explore the application and effect of anterolateral thigh free flap (ALTFF) and modified pectoralis major myocutaneous flap (PMMF) in the reconstruction of defects after radical resection of head and neck tumor.Methods:From November 2011 to November 2016, 394 cases with head and neck tumor, including 286 males and 108 females, aged 25-79 years, underwent radical resection. The defect was reconstructed with anterolateral thigh free flap (306 cases) or modified pectoralis major myocutaneous flap (88 cases). The result and the quality of life of patients are investigated, the advantages and disadvantages of the two flaps are summarized.Results:Survival rate of anterolateral thigh free flap and modified pectoralis major myocutaneous flap were 97.1% (297/306) and 97.7% (86/88) in 394 cases. The ALTFF group (3-4 h) and the PMMF group (1.5-2.5 h) have similar operative duration. Comparison of the UW-QOL scores of the ALTFF group and PMMF group 1 year post operation shows that the ALTFF group has significant advantages in appearance, speech and shoulder mobility, the difference was statistically significant ( P<0.01). Conclusions:Both of ALTFF group and PMMF group have high success rate in the reconstruction of defects after radical resection of head and neck tumor. Anterolateral thigh free flap is appropriate for the reconstruction of complex defects and modified pectoralis major myocutaneous flap is safer in patients with poor vascular conditions and systemic conditions.

Objective:To explore the application and effect of anterolateral thigh free flap (ALTFF) and modified pectoralis major myocutaneous flap (PMMF) in the reconstruction of defects after radical resection of head and neck tumor.Methods:From November 2011 to November 2016, 394 cases with head and neck tumor, including 286 males and 108 females, aged 25-79 years, underwent radical resection. The defect was reconstructed with anterolateral thigh free flap (306 cases) or modified pectoralis major myocutaneous flap (88 cases). The result and the quality of life of patients are investigated, the advantages and disadvantages of the two flaps are summarized.Results:Survival rate of anterolateral thigh free flap and modified pectoralis major myocutaneous flap were 97.1% (297/306) and 97.7% (86/88) in 394 cases. The ALTFF group (3-4 h) and the PMMF group (1.5-2.5 h) have similar operative duration. Comparison of the UW-QOL scores of the ALTFF group and PMMF group 1 year post operation shows that the ALTFF group has significant advantages in appearance, speech and shoulder mobility, the difference was statistically significant ( P<0.01). Conclusions:Both of ALTFF group and PMMF group have high success rate in the reconstruction of defects after radical resection of head and neck tumor. Anterolateral thigh free flap is appropriate for the reconstruction of complex defects and modified pectoralis major myocutaneous flap is safer in patients with poor vascular conditions and systemic conditions.

Objective To investigate CT features of primary ileocecum lymphoma (PIL),to improve the ability of CT diagnosis for the disease.Methods CT data of 12 patients with PIL confirmed by surgery and pathology were analyzed retrospectively.All of the patients underwent plain CT, and 8 cases of them also underwent enhanced CT.Results Among the 12 cases of PIL, there were mass type in 2 and diffused thickness type in 10.The length of the intestinal lesions ranged from 7.8 to 18.5 cm (mean 10.2 cm).Lumen was irregular or aneurysmal dilation in 9, and obvious stenosis in 3.Intestinal wall was soft in 10,and rigid in 2.Plain CT showed that the thickened intestinal wall was soft tissue density.Among the 8 cases performed enhanced CT,6 were approximately homogeneous enhancement, and 2 had small necrosis area without enhancement.Maximum intensity projection(MIP) displayed the lesion had blood supply from the branches of the superior mesenteric artery.Enlarged lymph nodes were detected around the lesions, in root of the mesentery, and in the retroperitoneum in 9.1 case was accompanied with intestinal obstruction,1 case was accompanied with intestinal perforation.Conclusion If CT examination found a homogeneous soft tissue mass in ileocecum with long extent, lumen dilation, soft intestinal wall,mild-to-moderate delayed homogeneous enhancement, PIL should be considered.

Objective To investigate the alterations of regional spontaneous activity in patients with classical trigeminal neuralgia (CTN) during resting state.Methods Twenty-seven patients with CTN (CTN group) and 27 healthy subjects (control group) were recruited and underwent a rest-state functional MRI.The regional homogeneity (ReHo) analysis was used to compare the differences of regional synchronization of spontaneous brain activity.And correlation tests were performed between ReHo values in the abnormal brain areas and clinical metrics (visual analogue scale and disease duration) of the disease.Results Compared with control group (P＜0.05,Gaussian random field correction),ReHo increased in bilateral primary somatosensory cortex (S1) and primary motor cortex (M1),right supplementary motor area (SMA),inferotemporal cortex and cerebellum,left thalamus,limbic lobe,parahippocampa gyrus,middle and superior temporal gyrus in CTN group;ReHo decreased in bilateral insula,prefrontal cortex and orbitofrontal cortex,right frontal medial cortex and superior temporal gyrus,left anterior cingulate area,supramarginal gyrus and cerebellum in CTN group.ReHo values in right frontal medial cortex was negatively correlated with the course of disease (r=-0.45,P=0.03).The ReHo values of left primary sensorimotor cortex were positively correlated with the visual analogue scale scores (r=0.46,P=0.02).Conclusion CTN patients has abnormal functional homogeneity of spontaneous brain activity in regions involved in the pain processing,which can help understanding mechanism of CTN.

Objective To investigate CT and MRI features of abdominal huge liposarcoma,and improve the preoperative diagnostic accuracy. Methods The CT and MRI findings of 1 7 cases with abdominal huge liposarcoma proved by operation and pathology were analyzed and correlated with pathologic subtypes retrospectively.Results In 17 cases,16 cases were located in retroperitoneal,1 case was located in the abdominal cavity.The average maximal diameter of the lesions was 17 cm.In all cases,main components of well differentiated liposarcomata (n=7) were fat density on CT and MRI,and enhanced slightly,3 cases were multiple lesions,1 case of sclerosing liposarcoma contained massive patchy calcification,1 case was fatless.Myxoid liposarcoma (n=5)were similar to cystic on CT and MRI features,enhanced with latticed or cloudy components slightly to moderately .Dedifferentiated liposarcoma (n=2)has both fat and soft tissue inside and the dividing line was clear.The soft tissue mass unevenly obviously enhanced.Mixed liposarcoma (n=3)had the imaging characteristics above different types,2 cases contained no fat composition.Conclusion Liposarcoma pathological subtype has diversity,and various subtypes have certain characteristic on CT and MRI imaging features.

Objective To investigate CT and MRI features of extragonadal primary seminoma and improve its diagnostic accuracy.Methods The clinical and imaging features of 8 patients with extragonadal primary seminoma proved by histopathology were analyzed retrospectively.Results In 8 cases,4 cases were located in intracranial regions,4 cases in the abdominal and pelvic cavity.Detailedly,roundlike solid and cystic tumors were seen in the basal ganglia and thalamus in 2 cases.The mass density and signal were inhomogeneous in the necrotic area with slight peritumoral edema and heterogeneous enhancement,and hemorrhage and metastasis of the third ventricle were occurred inone case.Shallow lobulated tumor was occurred in the pineal region forone case,which MRI features included slightly low signal on T1 WI,equal or higher signal on T2 WI,with obvious enhancement and peripheral cystic change.There was one case in the sella area with slight high density on CT routine scan,and on MRI,slight equal signal on T1 WI,equal or higher signal on T2 WI.The pituitary stalk was involved with thickening.Tumor in suprasellar region was obviously enhanced,with a small uniformity enhancement nodule in the mouth of corpus callosum.4 cases were occurred in the abdominal and pelvic cavity,shallow lobulated tumors with varying degrees of necrosis were found on CT with infiltrating growth and slight to moderate enhancement,and swollen lymph nodes were found in retroperitoneal and mesenteric root areas.Conclusion Extragonadal primary seminoma is rare,there are some characteristic imaging findings,which contributes to improve diagnosis accuracy when combining with clinical data.

Objective To explore CT and MRI features of peripheral primitive neuroectodermal tumors (pPNET) .Methods CT and MRI findings were retrospectively analyzed in 9 cases with pPNET confirmed by pathology .Of them ,8 patients underwent CT imaging ,and 5 patients underwent MR imaging .Results The lesions occurred in head and neck in 2 cases ,chest in 3 cases ,scrotum in 1 case ,right scapular region in 1 case ,and lower extremity in 2 cases .The lesions were more solitary (7/9) with round ,lobular or irregular shape .The longest diameter was between 1 .6 cm -13 .8 cm ,and the median diameter was 6 .2 cm .8 cases had blurred boundary .On CT plain scanning ,the lesions were mixed density with predominant isodensity .On MR imaging ,the lesions were slightly T1 hypointensity and heterogeneous T2 hyperintensity .Enhancement patterns were varied ,and the common way was mild‐to‐moderate heterogeneous enhancement .3 cases of them were closely associated with bone ,and showed osteolytic bone destruction . Conclusion The CT and MRI features of pPNET has lack characteristics ,CT and MR imaging have some value for localization diagnosis .